While more than 92% of Texas kindergarteners and 7th graders were fully vaccinated in the 2025-26 school year for each vaccine required to attend school, the coverage rates remained lower than before the COVID-19 pandemic, state data released Wednesday shows.
Of note in the latest report released by the Texas Department of State Health Services, the statewide measles coverage rate of kindergarteners increased from 93.2% to 93.3% after dropping about four percentage points in a decade. Also, the rate of kindergarteners opting out of the measles vaccine via a “conscientious exemption” increased by more than half of a percentage point, the largest single-year increase in more than a decade.
The latest data comes on the heels of the 2025 West Texas measles outbreak that resulted in the deaths of two school-age children. Texas lawmakers also approved a bill last year that did away with a requirement that the state must mail vaccine exemptions forms to parents, and instead, made the form downloadable. Parents must still get the form notarized, though.
“The bill made the exemption process more accessible, not more available, and it’s no surprise to us that when government barriers were removed that more parents exercised their right to make informed choices for their children,” said Rebecca Hardy, president of Texans for Vaccine Choice, supporters of House Bill 1586, the downloadable form legislation authored by state Rep. Lacey Hull, R-Houston.
Of the 6,176 public and private schools sent the vaccination survey, 87.7% responded to the state. Nearly 3%, or more than 150,000, of the K-12 students in the survey had a conscientious exemption for at least one vaccine on file at their schools, 20,000 more than the previous school year’s survey. In Texas, each grade level has its own vaccination requirement.
The statewide kindergarten exemption rate increased to 4.45%, double the rate from before the pandemic. Exemption rates for each 7th grade vaccine also increased.
“These numbers are concerning but not surprising,” said Becca Harkleroad, the executive director of the Texas School Nurses Organization. “We’ve been watching trust in science erode over the past several years, and the COVID vaccine rollout only accelerated that. Now, five years later, we’re seeing those consequences show up in the data.”
Historic measles outbreak’s impact
A year ago at this time, the state’s biggest measles outbreak in 30 years — which started in Gaines County and spread rapidly over the winter — was dissipating.
That may have had some impact on why the statewide measles coverage rate for kindergarteners grew, but 7th grade measles coverage stayed nearly the same and those gains in the lower grade did not occur in all counties.
Compared to the previous school year, 18 fewer counties had kindergarten measles vaccination rates at the 95% benchmark for herd immunity. The number of counties where at least 5% of kindergarteners had a conscientious exemption for measles on file increased from 98 to 132, representing 52% of all counties. Ninety six of 252 counties met the kindergarten benchmark of 95% vaccination against measles.
The measles vaccination rate for kindergarteners in Gaines County, the epicenter of the 2025 outbreak, increased by more than two percentage points to 80% but it was still short of the herd immunity benchmark due to conscientious exemptions.
The kindergarten measles coverage rate for Terry County, which reported the second-most measles during last year’s outbreak, increased by more than two percentage points to almost 96%. In the other two counties with more than 50 outbreak cases, El Paso and Lubbock, kindergarten measles vaccination rates changed by less than one percentage point.
“Good on the families in the outbreak affected areas who got their children vaccinated,” Rekha Lakshmanan, executive director of The Immunization Partnership, said. “While the increase in the vaccination rate is small, an increase is an increase, and we need to keep supporting and talking with families about the consequences of these diseases and why vaccinating has its benefits.”
Muddied data
While measles vaccination rates increased for kindergarteners, vaccination rates for Hepatitis B and whooping cough narrowly declined. Lakshmanan was particularly alarmed by the exemption rate for polio — 4.59% of kindergarteners – which doubled since the pandemic. Polio is among the more devastating vaccine-preventable and potentially deadly diseases because of the irreversible paralysis it can cause.
“The data in the immunization report is the tip of the iceberg of the consequences of loosening school vaccine exemptions,” Lakshmanan said.“I hope we don’t see a repeat of the 2025 measles outbreak because of more exemptions, but I’m not holding my breath.”
Harkleroad pointed out that this year’s kindergarteners were born around 2020, right as the pandemic was disrupting health appointments. “Lots of kids skipped well-child visits, which disrupted traditional vaccine schedules,” she said. “It’s plausible we’re just now seeing the consequences of that in our Hep B numbers since that series begins at birth.”
Harkleroad said it’s hard to tease out actual vaccine coverage because the data that school districts report to the state is a snapshot in time. Districts are working throughout the year to track down children’s vaccine exemptions and to understand which children just haven’t turned in proof of vaccination records or an exemption form, which the state tracks via the vaccine delinquency rate.
Kindergarten measles vaccination rates in Austin ISD, Spring ISD and the charter school network YES Prep Public Schools each rose above 90% due to substantial reductions in delinquent vaccination records.
The state defines “delinquency” as students who are not up to date on the immunizations required for their age and do not have an allowable document of immunity or a valid exemption on file with the school. In the 2024-25 school year, Austin ISD and YES Prep each reported more than 20% of their kindergarteners as being delinquent.
But measles delinquency rates remained above 5% in other large urban districts where delinquency rather than exemptions drove down vaccination rates. Delinquencies continued to outnumber exemptions in Dallas ISD, Aldine ISD and Houston ISD.
Within large districts, vaccine rates can still vary by campus. For example, Austin ISD records show 20 campuses had kindergarten measles vaccination rates below the herd immunity benchmark as of December, despite the 98% districtwide coverage rate.
Also, there’s a possibility that parents have vaccinated their children for some or all vaccinations , and have turned in an exemption form. The ease with which parents can now download an exemption is now easier for them than accessing their own child’s shot records, Harkeroad noted.
“The rise in … exemptions, combined with the drop in delinquencies, really muddies the water when it comes to actual vaccine coverage,” she said.
